MEDICARE: TRACY LYNELL PLAIR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide		FL

General Provider Information

NPI Number	:	1386135234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY LYNELL PLAIR

Provider Business Mailing Address
First Line	:	5130 PALM PARK CT UNIT 206
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4053
Country	:	US
Telephone Number	:	813-793-1495
Fax Number	:

Provider Business Practice Location Address
First Line	:	5130 PALM PARK CT UNIT 206
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4053
Country	:	US
Telephone Number	:	813-793-1495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2018
Last Update Date	:	05/27/2018

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Directions to “ TRACY LYNELL PLAIR ” Practice Location

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